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General NPI Number Information
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NPI Number | 1417399080
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Entity Type | Organization
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Legal Business Name | RELIANT PHYSICIANS OF SOUTHEAST TEXAS PLLC
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Dates
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Enumeration Date | 07/24/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 3070 COLLEGE STREET SUITE 401
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City | BEAUMONT
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State | TX
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Zip | 77701
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Country | US
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Telephone | 409-212-1533
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Fax |
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Provider Business Mailing Address
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Address Line | 3070 COLLEGE ST SUITE 401
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City | BEAUMONT
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State | TX
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Zip | 77701-4691
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Country | US
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Telephone | 409-212-1533
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. EARLE STEPHEN THORNHILL
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Credential | MD
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Telephone | 409-212-1533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 208M00000X
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License Number State | TX
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